Addition of Intrathecal Magnesium Sulfate to Bupivacaine for Spinal Anesthesia in Cesarean Section
- N. Banihashem
- Bahman Hasannasab
- A. Esmaeili
- Borhaneh Hasannasab
What this study found
Intrathecal magnesium sulfate did not provide a meaningful overall benefit for cesarean spinal anesthesia. It delayed sensory block onset versus control (P = 0.01) but did not improve motor block onset (P = 0.56), regression of four sensory blocks (P = 0.19), or produce a clearly significant extension of analgesia (P = 0.07). Heart rate and systolic blood pressure were similar between groups, and nausea/vomiting occurred in 3 patients in the magnesium sulfate group versus 1 in control; no neurologic deficits were observed and Apgar scores were similar. The authors concluded that adding…
- Study & population
- Adults aged 18 to 35 years with ASA class I-II status undergoing cesarean section under spinal anesthesia were studied in Iran.
- Intervention
- A single intrathecal dose of magnesium sulfate 50 mg was added to hyperbaric bupivacaine 0.5% 10 mg for spinal anesthesia during cesarean section.
- Key limitation
- The evaluation was limited to a single perioperative intrathecal dose in generally healthy ASA I-II cesarean patients, so generalizability is narrow.
View source
Open PDFOriginal abstract
Background: Spinal anesthesia is widely used for caesarean section. Addition of intrathecal magnesium sulfate to local anesthetics seems to improve the quality of block and prolong the duration of analgesia. Objectives: The present study was designed to examine whether addition of intrathecal magnesium sulfate enhances the analgesic efficacy of intrathecal bupivacaine in patients undergoing cesarean section. Patients and Methods: We conducted a randomized, prospective, double-blind, case-control, clinical trial. Eighty patients were scheduled for cesarean section under spinal anesthesia. The patients were randomly allocated to receive either 10 mg of hyperbaric bupivacaine 0.5% (control group) or 10 mg of hyperbaric bupivacaine 0.5% plus 50 mg magnesium sulfate (case group) intrathecally. Hemodynamic variability, onset and duration of block and duration of analgesia were evaluated. Results: The onset of sensory blockade was delayed in case group compared with control group, and this was statistically significant. The onset of motor blockade had no difference in both groups. The duration of motor blockade was similar. Post-operative analgesia was longer in magnesium sulfate group but the difference was not meaningful. The intraoperative hemodynamic variability showed no significant differences between groups. Conclusions: This study showed that the addition of intrathecal magnesium sulfate to bupivacaine is not desirable in patients undergoing cesarean section due to the delay in the onset of sensory blockade and the lack of significant effects of magnesium on post-operative pain.